241014 01/13/15 0Cqq-
�,. �Mf. CITY OF CARMEL, INDIANA VENDOR: 367774
r d ONE CIVIC SQUARE CARA GRAY CHECK AMOUNT: $********41.29*
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CARMEL, INDIANA 46032 C/O ESE CHECK NUMBER: 241014
'�'<roN CHECK DATE: 01/13/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 REIM 41.29 TRAVEL FEES & EXPENSE
PS==MD 87 8rA3R BOARD OF ACOOBIRS 6mnaAG Yom M IW"M
� MILEAGE C ��IS
ON ACCOUNT OF AFFROMIATION NO. Fon -
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AUTO LIMS1 NO. TOTALS
+ SPESDObWKR READING columns are to be used only when distance between cannot be determined by fined mileage or official highway,map.
Pursuant to tho provisions and penalties of Chapter 1S5,Acts 1833,I hereby certify that the foregoing account is Just and correct,that the amount claimed in legally due,after allowing all lust credits;
end that no part of the some has been paid. ,
Date y 2Z
JAN 05 2015
B� .
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of bill to be properly itemized must show; kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
367774 Gray, Cara Terms
9955 Fair Haven Dr E
Indianapolis, IN 46280
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
12/17/14 Reimb Mileage 12/5- 12/17/14 $ 41.29
Total $ 41.29
1 hereby certify that the attached invoice(s),or bill(s)is(are)true and correct and I have audited same in accordance
with IC 5-11-10-1.6
, 20_
Clerk-Treasurer
Voucher No. Warrant No.
367774 Gray, Cara Allowed 20
9955 Fair Haven Dr E
Indianapolis, IN 46280
In Sum of$
$ 41.29
ON ACCOUNT OF APPROPRIATION FOR
108 -ESE
PO#or INVOICE NO. ACCT#/TITL AMOUNT Board Members
Dept#
1081-99 Reimb 4343000 $ 41.29 1 hereby certify that the attached invoice(s), or
bill(s) is(are)true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
January 8, 2015
A&- M"Az
Signature
$ 41.29 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund